Pharma is recognizing the need to place additional focus on the patient. How should companies balance brand and patient engagement, and how do the two compliment each other?

Pharmaceutical companies need to begin using digital channels, and that data, to help focus where they’re serving their messages. They must also ensure that they are being sensitive to how a patient or a healthcare professional is going to engage, and what value is being delivered to them.

Pharma also needs to practice general sensitivity to people’s health and understand where they have the permission, and authority, to enter into that conversation. They’re not invited into all those conversations. When considering the data, companies need to pause and ask, before including their brand in the conversation; “is this really a space that we’re going to be welcome? Is this fertile ground for us to really have a dialogue about our brand?”

That’s the lens companies need to begin to look through when building communication strategies and tactical development.

The trend across pharma is “thinking beyond the pill” and really defining value. What recommendations do you have for pharmaceutical companies developing a focus on the value they offer for their patients? How can these companies begin to define what that value actually is?

I think for different brands that’s a different response. If we look at an oncology brand, you could have a physician who’s prescribing an oncology product which is incredibly beneficial, but may also have very bad side effects. It may be quite a challenge for the patients to be on the drug, but remain compliant. What does it look like when they begin to have that communication with the physician about the choices they’re making in regards to prescribing it? Not only is it standard of care, but is there going to be coverage? Is this part of the practice’s regiment of prescribing drugs?

But also look at it from the patient’s perspective, where a lot of these conversations happen around value. Companies must define how they begin to help the patient understand what those side effects are, and why they’re present, and why compliance is so important. They must identify how to have those conversations with the caregivers who are caring for a patient, loved one, family member, or a spouse.

These patients and caregivers are online, searching for answers, finding advocacy groups, and discovering the brand.com. Pharmaceutical companies must begin to help curate this information. But companies must understand what they have the authority and permission to speak about. Healthcare brands must know they can own the conversation around their drugs.

What’s the product, what are the side effects, how do we support the patients?

How do we actually have communications? What does pill-plus look like? When you move past pill schedulers, apps, and compliance tools, what do those campaigns look like? What does that communication look like and what does that core value look like when it goes back out to the patients and healthcare professionals? Companies must also define what actually happens when a patient has been engaged with the brand and travels through the patient journey.

But what happens when patients and healthcare professionals proactively reach out? Outside of personal communication, where you have a rep involved, what are those channels where physicians and patients can begin to interact with the pharmaceutical company to really get answers to questions? Many healthcare companies have fully established call-in numbers that are staffed with nurses and category experts. But how do companies move beyond those phone numbers into the modern paradigm of communication, where it’s social, two-way communication via chat, or email where you’re going to reach a brand expert and have that dialogue happen in a very quick turnaround?

What recommendations would you give companies about providing the right message at the right time, with the right tone?

Search, both paid and organic fills in this gap especially well. The right message at the right time and the right tone can be fulfilled by a landing page and search strategy. One of the things the life sciences industry doesn’t do well is set up landing page architectures that really begin to look at answering questions as people key them into search. Technology has trained the user, patient, and healthcare professional, to use semantic search, and just ask questions, both in a browser and through voice search. There’s a lot of opportunity in serving up those responses to the audiences.

This is an opportunity to be there when the user searches, both through paid and organic search, but then retargeting that person to make sure that you’ve answered those questions and haven’t missed the opportunity for engagement. Whether they’re a payer, a healthcare professional, or a caregiver, they are someone who is wandering, looking for information. Companies must reach out to this person in innovative ways; through display advertisements, picking the person up again in an app inside of another channel, a podcast, website, even personal communication where it’s pertinent.

With the recommendations that you’ve just defined, how do you recommend these pharmaceutical companies approach the use of social media to deliver, measure, and evolve the message that they’re trying to communicate?

I might point to a program like Gilenya. They’re actually identifying patients who are hand-raisers and identifying themselves as suffers from the disease. Novartis is proactively reaching out to them and using an 800-number in order to pull them into a channel, which they already have a very rich architecture and ecosystem to engage with the patient, and fully support them. It’s an excellent example of using multiple channels to be proactive and treat the patient.

Conducting outreach as a response to data is another example of how companies can begin to use not only social media, but digital media in order to make those decisions. Companies think physicians put on a lab coat and stop being consumers. A common objection to social media is “healthcare professionals aren’t talking about patients on social media”. And from a HIPAA compliance standpoint, that’s true. But must career professionals don’t go home at night and start Tweeting about the clients they’ve worked with during the day. However, there is a lot of searching, hashtaging, conference following, and online associations people engage with. This is very telling in regards to what physicians are doing in their day-to-day lives, and how we might be able to affect some of the decision making.

And this is true not only around actually writing prescriptions, but those people who hold influence over policy inside organizations. There are a lot of healthcare brands that are dealing with some very serious therapies that are truly beneficial. In order to really gain scale in mass, companies need to begin to target not just the physicians who are writing prescriptions, but those who really have influence over what the organization does from a standards of care standpoint, as well as those people who hold influence over policy.

Accenture published a paper on the “Rebirth of the Pharmaceutical Sales Force”. Accenture states that he sales rep is not disappearing, but rather is evolving. With a change in buyer profiles, the audience pharmaceutical reps are responsible for is becoming more complex. This is especially true when you consider the role of Integrated Delivery Networks. According to Accenture, IDNs own more than 60 percent of physician group practices. It’s these IDNs that now define treatment protocols.

I reached out industry thought leader and Director at Nuvera Life Science Consulting, Brad Davidson. As a social scientist with a background in linguistics and anthropology, Brad has studied the art and science of medicine and medical interactions, including rep interactions, in particular. Now focused on helping companies optimize the customer experience, Brad was very frank about the role IDNs can and should play in optimizing that patient or caregiver experience. We discussed the role of IDNs, their impact on pharma, and considerations for the industry moving forward.

What is the impact of IDNs on treatment?

We’ve always thought about the clinician as a decision-maker but they don’t make as many decisions as they used to. What people don’t fully understand is that we’re in an era of full on de-professionalization, where professionals can no longer act as they see fit in a vacuum. . In the past, doctors selected doctors and doctors trained doctors, and doctors were free to prescribe however they wanted to prescribe—no one challenged them. But today, doctors don’t run hospitals anymore, hospital administrators do. The individual experts are no longer in charge of the decisions, the system increasingly is. Today, even if the physician writes a prescription, if it’s not on label the patient likely won’t get it.

We’ve moved to a system-based process and we’ve come to despise expertise. We’ve created a push-pull system where doctors have very little autonomy. The push is that doctors have become, essentially, employees in many cases, not independent professionals, and thisplays into therapy selection. The pull is better data--companies can run real-world experiments in what works and what doesn’t, that extend beyond the limits of clinical trials and leverage financial modeling, health economics modeling, and experiential modeling. No one doctor can keep up with all of these trials and all of this data. You don’t want one physician treating patients eleven years behind the curve, and in an integrated system, you can’t do it anyway. To manage the emerging level of data, systems are needed for decision making.

What is the impact of IDNs on the sales model?

The industry as a whole is a laggard in making changes to their business model and is struggling with the transactional nature of the business. Younger HCPs would rather self-educate via edetailing at home in the evening. This leaves many companies wondering “how do we keep the field force busy?”

Small biotech companies are performing better because they didn’t grow up in the age of large sales forces free to walk the halls. There are also some medical device companies that are getting back to a field force focus to train clinicians on device usage, because that fits an educational need.

The big thing, I think, when selling to the IDNs is to be able to answer the “prove it” and “show me” questions that tend to be their response. Pilot programs are trending as is the desire for content relevant to their interests. There’s a huge gap in content delivered. .

If pharmaceutical sales reps are going to succeed, they must be able to talk about experiential outcomes.

How can pharmaceutical companies adjust for the role of IDNs?

Communicate more aggressively to patients. Patients are taking more responsibility for their health and treatment. They are researching their condition and evaluating treatment options. Companies cannot discount the role of the patient.

Talk to new audiences. Companies that are best-in-class are dedicating resources and effort to identifying underutilized audiences. There’s an example of one company that has an entire sales force targeted to pathologist. While the pathologists don’t make decisions, this company is trying to build relationships with those people who have lived in the hospital basement looking at slides because the tests pathologists run are determining treatment algorithms. Remember that modeling is being done by payers, health economics research groups, and chief medical officers. Influencers to those audience groups are key.

Communicate to payers. Communicate value regarding health data outcomes and budget impact models. Call on new people and bring new data to the conversation.

Improve your segmentation. Consider segmentation by context. Is your HCP audience constrained by formulary? If so, don’t waste efforts on those outside of the approved formulary. Work more at a policy level. Understand the decision-making algorithms about how and when to treat.

The shift in decision-making is having an impact on both the marketing and sales models for life science companies. More than ever, companies must segment, target, and personalize communications and educational information. Companies must understand the needs of defined audiences, and identify the opportunity in new audience segments. Sales must also have insight into the behavior and interests of each of these audiences, as well as the relationships across key influencers.

Brad concluded our discussion with this piece of advice; “We’re moving to algorithmic advice. But it’s becoming impersonal. The group that can tie algorithmic advice to personal experience will win.”

How is your organization working to personalize the oftentimes impersonal experience?

Healthcare organizations recognize that they must focus on the entire care management lifecycle. To do this they must target communications around healthcare offerings. Example: a company started a marketing campaign to target woman age 30-50 for their cosmetic procedure. Shortly after the campaign launched, the company realized a better target for their procedure is males over the age of 65.

Organizations must also extend this life-cycle focus and care management content across multiple channels. Google Think surveys found that 76% of patients were using hospital websites for research, compared to 32% using TV, 20% using magazines and 18% using newspapers. Of patients who found physicians and private practices on their mobile devices, 44% scheduled an appointment. Year-over-year the number of consumers using mobile devices to search for healthcare services increased 22%. 52% of smartphone users gather health-related information on their phones.

It’s imperative that healthcare organizations understand what content should be delivered to each audience segment, and across the appropriate channel.

Social engagement is no limited to the major channels like Facebook, Twitter, and LinkedIn. To meet regulatory risk concerns some organizations are building their own social platform that physicians can use to self-educate and engage with one another. You can’t control the conversation but you can be a part of it. Utilize your advocates. Be authentic. Remember that response is important.”- Shannon Hartley, Managing Partner, Healthcare Industry Leader Rosetta

“Not responding to a social post is like not answering the phone. Some of our biggest mistakes were underestimating the volume as well as the commitment around the activity required. Develop a digital scorecard. Measure engagement. Evaluate the volume and response. Begin to understand the sentiment around both your organization and your competitors.” - Darren Rodgers, SVP and CMO Healthcare Service Corporation

Jackson Healthcare adopted a “give more than we ask” attitude which resulted in strong physician relationships and an engaged community. With marketing automation technology you can better emerge as a Thought Leader. Survey and identify trends amongst physicians. Drive Community Development. Recognize the best practices and successes in your community. Engage by Giving More than Getting. Connect with research and proven best practices

Optum has achieved what many organizations struggle with, they have successfully engaged with the C-Suite. When launching their new Accountable Care Solution they revamped their content marketing efforts. By identifying and mapping their content journey, Optum has connected, and engaged, with key decision makers by delivering the information they're most interested in. And they've done this using a smart form strategy. By developing a unified content journey consisting of 6 pieces, Optum established themselves as a trusted advisor in the arena of health reform. Optum also focused their content efforts. They targeted their content on organizations that were chosen by Medicare to participate in its Pioneer ACO pilot and its Medicare Shared Savings Program. These efforts resulted in a 700% improvement in sales accepted leads.

Healthcare organizations are working to accessa 360-degree view of their relationship with the physicians. Organizations should track all activities related to the physicians, their affiliations, issues, comments and preferences and their referrals. This information should be captured within CRM systems but also passed into marketing cloud technology to dictate segmentation and personalization.

By capturing the explicit and implicit information across the integrated systems, organizations can monitor the performance of physician liaisons and referring physicians by viewing reports and dashboards. Analyze this data to understand how liaison activities are leading to referrals and commercial value.

“As quick as the patient wants information and feedback, physicians want it faster. More and more physicians are using their mobile devices. Clinicians are having text conversations with physicians via their mobile devices. You must also commit understanding the needs of the patient in both content and content delivery. For example, don’t overemphasize the value of videos. Healthcare wants to build a video for everything, but videos don’t engage the patient. Videos are often boring and disenfranchise the patient.” - Margaret Coughlin, SVP and Chief Marketing and Communications Officer with Boston Children’s Hospital

Analytical information

Support Your Decisions With Data. Healthcare organizations can finally obtain that data insight to make smarter business decisions. By capturing and analyzing an individual’s Digital Body Language across all channels, companies cannot only develop that sought after universal profile but also understand things like cost of recruitment efforts, cost of acquiring new physicians, and effectiveness of their communication outreach across regions.

Organizations can also begin to understand revenue potential. You can see programs are not only driving the most engagement, but are also the most revenue. You can also begin to understand which resourceshave the greatest potential to grow revenue and which are generating the greatest return on investment. In short, you can identify which resources and programs to invest in.

Through the development of strong content, unification of digital channels, and focus on data forensics healthcare organizations can grow revenue, increase quality without sacrificing volume, recruit and retain physicians, and make strategic business decisions based on fact, not opinion.

According to a report by IDC, sixty-eight percent of life science companies are expected to increase overall sales and marketing IT spending. Additionally, total IT spend in the sales and marketing space is now exceeding $3 billion. And while it’s exciting to see life science companies making an investment in their sales and marketing initiatives, many are not thoroughly qualifying their objectives before making these long-term investments.

Without base-lining current programs and defining future objectives and KPIs, many companies may find they’ve implemented a solution that doesn’t meet their needs and deliver the customer experience they desired.

Below are 32 questions for life science companies to answer as they consider future marketing and sales technology investments.

What is our current focus and effort, as well as desired focus and effort, across clinicians, patients, caregivers, payers, hospitals, pharmacies, and policymakers?

When targeting clinicians are we focusing on a specialist or the entire care team involved in treatment?

What programs do we currently execute to educate and influence clinicians about our services and offerings?

What programs do we currently execute to educate, support, and enable patients in both the pre-diagnosis and post-diagnosis stages?

What is the performance of each of our programs across each persona?

Which offers engage each persona, and do these offers vary by need, or are we simply offering coupons across the board?

Have we audited and mapped our content to each persona and journey?

Have we defined our content gaps and developed a plan for further content development?

How do we approach formulary approval and what programs, if any, do we execute to the payer audience?

Do we focus on organic list development, or do we rely entirely on rented lists for HCPs?

How do we build lists organically for patients via inbound marketing efforts (blogs, display ads, portals) or do they rely on referrals from HCPs?

We link to non-branded disease awareness websites. Have we clearly defined what role these sites play in our communication strategy?

We talk about improving our social media initiatives. Do we want to use social to build disease communities, deliver wellness programs, educate on drug development, increase brand awareness or are the social channels more for sharing corporate information?

What are our “offers” used to drive digital ad conversion in publications and are they targeted for that publication’s audiences?

What are our hit rates? What web traffic is coming from each channel? Do we know who are visitors are, how long they stay, where they navigate to, and which pages they bounce from?

Which links and offers are driving the most conversions to each brand? Are we converting to a brand page or to a corporate page?

Have we defined the journey for each of our audiences? How does the journey for HCPs, patients, caregivers and payers differ for those brands?

Are we evaluating metrics and reporting around communication performance by region, specialty, sales rep, disease, clinical trial, and medication?

Are we evaluating metrics and reporting for advocate referral opportunity by region, specialty, advisory board participation, and school?

What has been the adoption rate of previous marketing and sales technology? Why have some systems succeeded, and others failed?

Which marketing technologies and products are we currently using?

What is our main goal in utilizing marketing technologies?

How do our marketing technologies currently work together?

What’s working well? What would we like to work better?

How is data integrated into our current marketing process?

What is the biggest challenge we are facing with our efforts?

Which initiatives are currently prioritized in our company?

What results do we want to see over the coming 12 months?

Should we consider a digital marketing center of excellence?

How do we define success? What are those KPIs we want to point to as a marketing organization? Does our technology allow us to report on those segmented metrics as well as C-Level metrics?

The 32 questions may be very easy for some companies to answer, but difficult for others. Not all questions may apply to each company, and there are certainly many more considerations for companies as they evaluate resource and budget requirements.

What these questions should do is jog the strategic mind of life science marketers. Ensure there is a firm understanding of baseline programs and performance, and defined direction for future initiatives and KPIs.

As you consider future marketing and sales investment, what questions would you add to the list?

My Husband had double hernia surgery. While I'm sure he's thrilled I'm sharing that information, his experience was a fascinating in-the-field research study for me. Once his surgery was scheduled, all pre-surgical paperwork and registration occurred online, a week before the procedure. The payer coverage was confirmed, data was captured, and medical history was documented. The morning of the surgery we arrived at the hospital and were taken right back to the pre-op room where pre-op procedures began. With the exception of a few verification questions, no additional paperwork was required and everything in the hospital's system was accurate and up-to-date.

As they administered his IV and took vitals, a video played on the large TV in his room explaining the procedure, the process of administering the anesthesia, and what to expect after recovery. After he was wheeled back I could order his prescription from the same TV and have it delivered to the room. Throughout the procedure I would receive calls to my cell, from the surgery staff, providing updates. I could also watch a screen that would provide a status update (using a patient code) of where he was in pre-surgery, prep, operations, recovery, and post-op. Once released, we received discharge instructions in paper form that were also available on the portal. Over the next few days my Husband could log on to the portal, see test results, and post questions to his surgeon for follow-up.

But It Stopped With The Discharge

But that's where the seamless patient experience ended. Once we left the hospital, all proactive communications ended. My Husband had a series of side effects but when he posted his questions to the portal, he never heard back. His test results were never posted. He found out the results a week and a half later at a follow-up appointment. And at the follow-up appointment there were no FAQs provided, or a physician discussion guide offered, to help him get the most out of his visit.

Like most experiences, communication tends to falter in the "post-event" process. One industry is starting to improve on this experience.

A Lesson Learned From Sports Entertainment

Sports Entertainment has developed a focus on the "driveway to driveway fan experience". This is the experience a fan has from the time they leave home, to their time spent at the stadium, to their return home. Sports teams are driving engagement with fans through communications focused on a fan's favorite player, favorite opponent, birthday, or other personal data.

By leveraging the data on the fan these sports teams can send targeted promotions via SMS before the fan leaves for the game. Once at the game the stadium can send push communications based on personal preferences, stadium purchases, and game activity. As the fan leaves the stadium follow-up communications, surveys, offers, and game highlights can be shared with the fan through email, social media, and SMS. Many sports teams have noticed a marked improvement in ticket purchases, season ticket subscription renewals, and NPS improvements.

A Driveway-To-Driveway Experience

The hospital got the pre-surgery and procedure communications right. But they should've focused on the entire driveway-to-driveway experience. Noting that my Husband has a history of adverse reactions to anesthesia could've triggered a follow-up email about possible side effects, like back pain. Having a nurse call that evening or the next day could've alleviated concern over pain and side effects of the pain medication. Responding to the posted questions on the patient portal could've eliminated inbound calls to the nurse team and unnecessary follow-up visits.

While the hospital isn't looking for us to be "returning guests" like a sports team, they are concerned with re-admittance rates that can result from improper post-op care. The hospital does care about patient satisfaction scores, NPS, and developing advocates that can result in referrals and donations. Through a driveway-to-driveway program, hospitals can generated their desired results, and patients can experience the continued care and follow-up required after leaving the hospital.

How are you developing a driveway-to-driveway experience for your patients?

Life sciences marketers in pharmaceuticals, biotechnology, and medical device manufacturing need to reach many complex audiences. Modern Marketers in life sciences are delivering personalized messages by channel and influencer, increasing revenue, and reducing costs. They use marketing automation technology and expertise that speaks their language.

Get the 360? customer view with Digital Body Language.

Create and send highly personalized communications across all channels. Target and segment dynamically according to audience. Use social, profile, and website data to trigger automated communications for immediate engagement with prescribers, providers, and other healthcare professionals.

One of the most talked about trends in marketing is Account Based Marketing. Unlike more traditional targeting where you focus on an industry, product, or channel, ABM brings everything together to focus on specific accounts. Companies develop frameworks, scoring, measurements, and alignment tactics to support this strategy. One of the greatest benefits of ABM is a focused effort that extends beyond awareness, through demand generation, into nurturing, and eventually advocacy.

But this leaves many in the life sciences space feeling eliminated from an effective marketing approach and wondering what more they can do to drive relevant communications and align and support their sales organization. In truth, what drives ABM implementation is very relevant in life sciences. These pharmaceutical, biotech, and medical device companies are looking to gather intelligence, drive demand, encourage conversion, and identify new advocates.

So how can life science companies implement an account based marketing program when they don't market to traditional "accounts?"

What Classifies As An Account?

One of the first steps in the ABM process is defining the universe of accounts to be targeted. It's within this first step that many life science companies give up because they're not sure how to define accounts. But if we broaden our definition of accounts beyond individuals working within the same organization, then we can begin to identify ABM opportunity. For example, a life science company may want to target all physicians within the same ACO, or perhaps cardiologists operating out of the same hospital, or maybe even all endocrinologists in a region that accept the same payer insurance.

What Are My Account Requirements?

With the "accounts" defined you can now begin to identify the commonalities and difference tied to their drivers, challenges, and interests. This should require a fair amount of research to understand requirements. You can consult prior Digital Body Language that aligns with the personas of those accounts and identify the journey and supporting content that best aligns with their interests. It's important to remember that the engagement and interests of these "accounts" will vary, and not just by specialty. A physician associated with an ACO will probably take a greater interest in patient impact and satisfaction than one that still remains in private practice. The value-content you deliver to a provider who accepts BCBS versus Anthem will also vary depending on your relationship with the payer.

What Do I Measure and Score?

Equipped with this information you can now begin to plan marketing activities that align with the objectives of sales and the larger business. Ensure that your sales and marketing teams align to the campaign framework as well as the agreed upon scoring models and processes for follow-up. You'll want to measure account revenue potential, account communication coverage and engagement, and sales activity corresponding to each account.

How you measure and score these accounts will also vary depending on whether your ABM strategy is tied to intelligence and clinical research gathering, brand awareness development, decile prescription conversion, edetail or CME nurturing, or KOL advocacy. Ideally, your ABM strategy should flow beyond awareness and demand creation and into post-customer lifecycle stages.

Building out the framework for each of these steps takes time, as does executing an effective ABM program. But with a greater understanding of how the broader ABM framework can be applied to life sciences, now you can execute step 1 and move further through the strategy development process. If you're looking for more detailed information on building ABM frameworks I recommend you consult the information provided by SiriusDecisions. If you're interested in exploring account based marketing application in the life sciences space I'm happy to field any questions you might have.

There's no question that policy changes have had tremendous impact on the healthcare system. These changes can be felt through the provider and HCP networks, payer organizations, pharmacies, and especially the patient population. These new policies are holding everyone accountable. The provider and HCP networks are accountable for the quality of care, payers and pharmacies are tasked with balancing quality care with achievable cost savings, and patients own more responsibility in their own adherence care as well. As someone stated, "we've moved from a volume based healthcare system to value based healthcare system".

We are seeing a shift in healthcare from a population approach to an individual approach. With the data now available, and the policies now in place, healthcare is beginning to focus on each individual patient.

Personalized Pharmacy Care

One of the best examples of this individualized focus can be seen in compound pharmacies. Compound pharmacies develop customized medication care for each individual. The development of individualized prescriptions accounts for multiple variances like other medications prescribed, height, weight, body type, diet, lifestyle, even flavor. Pharmacies recognize that the chemistry of each individual varies greatly and medications must be adjusted to account for these variances. Additionally, instructions and patient follow-up communications must be personalized, accounting for the differences in side effects, prescription care, and adherence.

Customized Adherence Programs

But just as treatment and medications are focusing on the individual, its imperative communications follow suit and support the needs of each individual. For example, let's look at medication adherence communications. Medication adherence programs have evolved from the "take 2 and call me in the morning" practice, to more advanced apps that remind you it's time to take your medication. Many applications now provide reminders around medication consumption, diet, and exercise on the channel which you prefer. But just as medications need to be adjusted for the variances in individual chemistry, adherence programs need to be adjusted to the individual.

Lifestyle has an effect on how frequently someone can consume medications, the hours in a week they can exercise, and the caregiver support available. The issue is not always "are you taking the prescription?" but instead "are you taking the prescription the way it was prescribed?" Medication adherence programs must certainly account for preferences in communication distribution, but also must manage the dynamic content accompanying these personalized medication and wellness regimes.

Multichannel and Multi-relational

This individualized care must finally be communicated back through the entire care ecosystem. It's not just multichannel communications that must be managed, but also multi-relationship communications that must exist amongst HCPs, providers, payers, and pharma. Systems must exist that facilitate the visibility and transparency of data, ultimately working together to help the patient.

Identify opportunities to communicate with the patient throughout the entire healthcare ecosystem. Segment and target communications based on both the multichannel data, as well as the multi-relationship profiles. Ensure you're matching communications with preferences, interests, lifestyle, and individualized care.

Each individual in the life science ecosystem is accountable for the care of patients. Understand your role and responsibility and map your communications to others.

How are you moving from a population approach to and individual healthcare approach?

The state of pharmaceutical sales is in flux. The instability in the pharmaceutical space has caused companies to make cuts, and sales has been greatly impacted. Reports from SDI Health indicate that the number of sales representatives in the United States has decreased from a high of 101,818 to about 81,780, representing a 20% decline. Equally important is that the cost per engagement for sales calls remains high, ranging from $142 to nearly $600 per call.

These costs are forcing sales to perfect their field efforts. Sales must understand where to allocate field resources, and equip them with the knowledge to provide a valuable engagement to the HCPs. Marketing must identify which practices and physicians they should target with eDetail and eSample programs.

HCP-Centric Sales Model

Because of this change, many companies are shifting from a brand-centric to HCP-centric sales models. Reps are covering more territory and carrying more products. They have to have a tremendous understanding of the service and value of each product. Now, targeting and focusing sales effort is becoming paramount. Pharmaceutical companies must understand the Digital Body Language of physicians and practices. It's imperative reps enter the call knowing what the HCP wants, and with the required education to manage the knowledge share.

Hybrid Sales Model

Another emerging sales model is the "hybrid" sales representative. Hybrid representatives have defined geographic territories and specific sets of target HCPs, just like typical field representatives. But they reach their physicians through a variety of channels like face-to-face, phone, and video and at times, like work day, after hours, weekends, which are preferred and most convenient for each physician. This model is proving to be very popular with physicians; 72% of survey respondents want "more" or "significantly more" hybrid representatives calling on them.

So with these new models, how do pharmaceutical companies know which practices to target with field sales versus eDetailing and eSampling programs? How do sales and marketing know when to target, who to target, and what information is most relevant to the practice?

Multichannel Targeting

Just as companies leverage multichannel marketing to engage and educate, they must also implement multichannel targeting. Targeting needs to extend beyond the singular data found in marketing automation. Currently, reps are told when to target a physician or practice based on their Digital Body Language. Marketing evaluates which marketing assets they clicked on, how much time they spent on a webpage page, and what information was submitted via a form. And while these traditional scoring models are a vast improvement from cold calling a list of names, they?re not as targeted as they could be.

Now, tools like Lattice Engines enable the marketing and sales organizations to identify which accounts to engage for selling and retention. Lattice introduces other analytics into your scoring model. They look at the practices' growth indicators, news events, activity against 3rd party assets, and funding or grants received by the physician or practices.

Using Lattice's modeling engine, companies can also pull in data from internal systems to evaluate prescription patterns, brand sample orders, products prescribed by practice, detailing history, and program enrollment. Companies can also evaluate the behavior of similar practices, like pediatric practices, oncology practices, and cardiology practices.

Predictive Behavior

This multichannel targeting provides advanced insight into the probability of the physician to prescribe prescriptions. By creating likelihood rules, sales reps can identify which practices to target for new prescriptions and decile conversions.

Marketing can understand which content will contribute to that prescription conversion. Marketing can also compare practices in similar selling situations. Marketing can the aggregate the view and format it so it's most relevant to the sales person.

Managed Healthcare Executive recently published an article entitled "The Future of Formularies". The article states that specialty drugs are expected to account for 50% of all drug costs by 2018 and that formularies will hold more relevance and impact as the number of older adults and insured individuals through the Affordable Care Act increases.

Pharmaceutical companies must begin to adjust their communication strategies around these future changes. A few areas that will see the greatest impact are targeting disease communications to unknown patients, contributions in the offloading of medication costs, and reinforcement of medication adherence.

Below are recommendations on how pharmaceutical companies can begin to address those challenges.

Disease Awareness Targeting

When reviewing and analyzing the future trends in formularies, John Mackowiak, VP Pharmacy and Education for the Academy of Managed Care Pharmacy, emphasizes the need to focus on diseases awareness targeting.

"Tier 5 is extremely costly but may save money in the long run. For example, the new Hepatitis C drugs may prevent a costly liver transplant; on the other hand many will live with dormant Hep C and never need the new medications. How do we find out who needs these drugs and provide them in the nick of time to offset expenses?"

Pharmaceutical companies must have technology in place to capture disparate data as well as staffing that can make sense of it. Pharmaceutical marketers must succeed at driving strong inbound traffic through the development of disease education content. Marketers must convert that inbound traffic through affordability and adherence programs on patient portals. And further communications must be segmented, targeted, and personalized to the Digital Body Language of each individual patient and caregiver. And this must all be accomplished in real-time.

Medication Affordability

According to a report by Consumer Health, it's estimated that 46% of the people in the United States take at least one prescription drug. This means that there were 3.3 billion prescriptions dispensed in 2006. The total cost of all of these prescriptions was $192 billion. The average cost to fill one prescription with a brand name drug is approximately $111.02, while a generic prescription averages $32.23. This means that you would have to pay over THREE times as much for a brand name drug than as a generic one.

Pharmaceutical companies must educate the patient and the physician on the efficacy of their drug, as well as provide cost-alternative solutions. By providing physician and patient discussion guides around efficacy and drug alternatives, as well as providing co-pay programs, pharmaceutical companies can gain awareness and favor with both physicians and patients.

Bob Taketomo, President of Ventegra, recommends "adopting strategies to keep drugs affordable, while ensuring that patients can access what they need -- a move toward more deductibles, out-of-pocket maximums and flat co-payments, along with stronger management of deductibles and coinsurance."

Leverage co-pay programs. There is an 18% increase in adherence when co-pay programs are offered. Utilize patient portals as places to educate as well provide opportunities for patients to request samples, coupons, and co-pay programs. With the change in formularies there will be "additional emphasis on co-payments, along with stronger management of deductibles and coinsurance".

Medication Adherence

Pharmaceutical companies recognize that there is a lack of medication adherence. They must develop communications that generate awareness of medication compliance and tools available for healthy living and disease management like medication tracking tools. They must work with HCPs and payers to communicate the risk and rising cost impacted by non-adherence. This is especially true when targeting the use of expensive specialty drugs.

Pharmaceutical companies must give consideration to developing healthy living communications that educate both patients and caregivers on proper dieting, exercising and taking medication. These communications should be very specific to the disease of the patient. Companies should also provide a medication notification form. This form should allow patients and caregivers to set-up alerts for medication email reminders. It's also important for companies to leverage multiple forms of communication. Extend beyond email and leverage other tools like SMS. These SMS communications, much like the emails, should be sent regularly, based on the medication notification form submission, reminding the contact to take medication as indicated.

David Calabrese, RPh, MHP, VP and Chief Pharmacy Officer, Catamaran states, "We manage drugs from an overall care management perspective and if consumers receive what they need, take them correctly and receive appropriate follow-up, medications can deliver value".

We all know that marketing's primary objective is to assist in driving revenue. But for many life sciences companies that becomes secondary because of competing projects and constantly managing through the compliance minefield.

Many organizations are also implementing new sales processes and working with marketing and sales organizations with low tenure. Life Sciences marketers struggle to support multiple brands and sales organizations efficiently. Marketers often become reactive to the needs of their teams and sales organizations are tied to the pace of the marketing department.

Marketing needs to become agile and proactive in the support, education, and enablement of their sales teams.

Start with the stars

Avoid launching new initiatives at the end of a fiscal quarter. Schedule a review of new programs with your top performing reps, at the beginning of the sales quarter, and preferably when they are in the office. Focus on the top performing reps because they are more apt to embrace new solutions to aid in their efforts. If they have success others will soon follow.

Feed them bites, not meals

The last thing sales wants is another tool they "have to use" simply because its part of the process and the company needs that information, on record, from the sales team. While tools and technology are great, roll out one solution at a time, and only after the sales team sees positive results from the previous tool.

Don't just explain, demonstrate the value

Merely explaining the benefits of sales tools will not equate to adoption. Identify the top sales opportunities for those reps and showed them the activity against those contacts in CRM. With the right tools sales can see form submission data, view marketing content, and set-up web alerts for specific contacts. This will get their attention. Eliminate the complaint that sales doesn't know what marketing's doing. Provide the forensic evidence of their contacts? activity so sales can approach their contacts better educated. Sometime you'll need to be proactive. Send reports to the sales organization with the results of their account activity. As the sales teams began to see engagement you will see traction with the sales teams.

Work together, sell together

Many companies know that activity within their database is occurring, but that activity is often occurring as unknown visitor activity. Use your sales teams to assist in converting unknown activity to known activity. Because they communicate one-on-one they have a higher chance of conversion. Develop messaging together that is determined by conversations that occur between sales and contacts. As you continue to demonstrate support of sales efforts, the sales organization will begin to open its door. The sales people will become much more comfortable sharing the successes and failures of various messages and campaigns.

Show them you care

Develop weekly "care packages"for your sales teams. Each week provide suggested email templates your sales people can utilize. In that template outline a key message for the week along with a corresponding blog entry and offer like a white paper, eBook, podcast, or webinar that supports that key message. Allow them to customize their communication around this key message based on the conversation that occurred with the contact. Not only does this result in more valuable conversation, but your sales members engage with this material and are learning as well.

Repetition + Reinforcement = Retention

Reinforcing the value of the exercises above can be a challenge. Consider creating an online tutorial for your sales team. This can be done by recording a webex or even using a learning management system. When developed in a LMS you can extend beyond basic tutorials and walk the teams through exercises and tests. Additionally, sales managers can see how their teams perform and where they need assistance. Ensure this is training reps can also refer back to and walk through the exercises again at any time.

Many believe there is a gap in sales talent, but the challenge appears to be the inability of most sales organizations to provide the sales reps with the specific tools and training they need to be successful. This falls to the company to define a true sales process, share best practices, and coach sales reps to success. Companies must develop a sales enablement program.

When I talk to different organizations about sales enablement, I typically get a lot of blank stares. So while it?s certainly becoming a more popular term, to many, the term sales enablement is still unfamiliar. How do you define sales enablement?

It?s a good question. I think why it?s so confusing and why it varies is because it?s a function of where the role actually sits within an organization. If sales enablement sits in marketing, how folks view it tends to be on content enablement and the handoff between marketing and sales. And if sales enablement sits in sales there?s a tendency to focus on only sales training.

How I view sales enablement, and my definition of it, is a really nice marriage between those two functions. It?s about providing the process, the tools, and the training that any revenue generating role within an organization needs in order for them to be able to close more business faster while still growing personally and professionally in their role.

You?ve introduced sales enablement programs at several companies. Why do you believe this is a growing practice, and why are companies making the substantial investment in this process?

I?ll explain it best by telling a brief story. Way way way back, between my first and second year of university, I got a job as a telesales rep for an industrial manufacturing supplier. On my first day I was given a tour of the office. I filled in all my HR paperwork, and I was shown to my desk. On my desk was an industry phone book - a phone book listing all the companies in the industry that we were selling to - and a computer terminal. I was also given a stack of product brochures. I was told to call through the phone book and sell whatever I could that was in the product brochures and any leads that I generated I had to record in the computer terminal.

No training, no sense of how to use the equipment, and I had no idea what the products did or what the value proposition was or why anybody I was calling would actually want to buy these products. Needless to say I heard a lot of ?no?, and I heard a lot of dial tones throughout that summer.

That was 20 years ago, and organizations today still do this to their sales people, which is really disturbing, because your sellers are the most expensive resource in your organization. And they have the highest probability of turnover if they?re not successful. So why would you leave these folks to fend for themselves? That realization is why companies are starting to make the investment in their sales organizations to set them up for success.

A lot of companies view development of a sales enablement initiative as overwhelming. Considering the work you?ve done with Vision Critical, what advice do you have for a company that?s looking to launch a sales enablement program? Where do you recommend an organization start?

It can be a very overwhelming and daunting task. I look at sales enablement in three key categories.

The knowledge that the sellers need in order to sell the products and services the company has.

The sales skills that they need to get their jobs done and grow personally and professionally.

The behaviors that the organization wants the seller to exhibit that is in line with the corporate brand and the corporate culture.

You have knowledge, skills, and behaviors. Using those three as your guideline, start with an analysis of what?s working, and what?s not working. Ask the sales organization where they are struggling or what?s working really effectively. Then you can start to categorize the responses in those three buckets: knowledge, skills and behaviors.

Once you?ve done that you can start to identify the first few quick wins that you can achieve to get the enablement ball rolling. I tell this to our selling organization all the time: it?s a journey, and there are many steps that you have to take along the enablement journey. It?s not a quick fix, it?s not an overnight thing.

So how does a company know when they?ve succeeded? What are some sales enablement KPIs to consider?

That?s really the magical question, and KPIs are an area that I?m still exploring at Vision Critical. My answer to your question is going to be a little lean. Right now we?re tracking time to first close for new reps, as they?re part of an onboarding program. I?m interested in any correlation to completing their onboarding process and how quickly it takes them to close their first deal.

I am testing new ideas with integrating a learning management system into our CRM, which I hope will allow us to track completion of tasks, learning modules and their guided learning paths and see if there?s a connection to the pipeline that they?re developing and the business that they?re closing.

Currently my effectiveness tracking has been largely anecdotal. It?s seeing how the sales team as a whole is performing. Are we hitting our number? I?m compensated on the company hitting their target, so when we do that I consider it a win. Presently there?s no direct correlation to the sales team achieving target and the training, certainly not measured in our CRM, but I make sure that the executive team is reminded that sales hit the number because they took all the training.

Gamification is one interactive platform that most industries are still trying to understand. Gamification enhances customer engagement by collecting additional data, crowdsourcing ideas, and educating in a fun interactive way. Some companies cite a 100% to 150% pickup in engagement metrics including unique views, page views, community activities, and time on site.

In the pharmaceutical space, companies are looking to extend gamification value beyond website engagement. These companies are also using gamification to drive changes in patient behavior.

Last fall, Sanofi launched their diabetes game for children. The app can be used on mobile devices as well as PCs. Through a ?wise sensei??, players learn about living with Type 1 diabetes, managing hypoglycemia and hyperglycemia, and maintaining a healthy diet. They can earn points as they navigate through the game, eventually becoming a ?Grand Master?.

The objective of the game is to educate kids about their disease, as well as share these learnings with others. And because kids spend so much time in school, Sanofi wants to educate the teachers and classmates too. Teachers have access to an education pack containing the Mission T1D game, videos, and quizzes that can be used to educate the classroom.

Bayer also introduced a Type 1 diabetes game. This games synchs the Bayer DIDGET Meter with the Nintendo DS. Kids are encouraged to test and enter their blood levels into the system. When the levels are within the target range for that child, tickets are awarded which can be used for game enhancements.

Gamification Is Not Just For Kids

Bayer and Sanofi have found gamification to be a great way to educate and reinforce adherence amongst kids. But gamification can also have a profound effect on adults. This is especially true when you see how some are using gamification to focus on improving the wellness of the patient beyond the pill, beyond medication adherence.

Through Wii Balance Board games like yoga, snowboarding, and dancing, practiced 30-40 minutes for 5 days a week; MS patients are experiencing an improvement in their balance. The research team also used diffusion tensor to monitor physiological changes in the patients? brains. They?re finding that this gamification is addressing, and positively impacting, wellness.

Gamification is certainly opening new doors for pharmaceutical companies. Gen-Y and Millenials have grown-up in a device-centric world with self- education a mere thumb-tap away. Gamification offers pharmaceutical companies a new opportunity and channel to connect by providing tools for self-education, adherence, and improving wellness lifestyles.

But therein lies the problem; most patients have zero awareness of these services. In fact, when I read this report I had no idea what type of ?pre-treatment patient service? would be offered by a pharmaceutical company. I reached out to almost a dozen connections across the pharmaceutical space looking for answers and all responded with having never heard the term.

But there are several pharmaceutical companies who are unifying the relationship across patients, HCPs, and hospitals. These companies have recognized the significant opportunity in providing services at the earliest possible point in the patient journey.Currently one-third of patients believe their physician is inaccurate in producing patient preferences. Because of this, these pharmaceutical companies have done one better. While there?s an issue with patient preference accuracy, pharmaceutical companies recognize that patients prefer to receive healthcare guidance from their physicians and care teams; therefore they?re driving awareness around their patient services with HCPs. This is developing a stronger relationship between pharma and HCPs because the pharma companies are enabling the HCPs with educational content to better service and engage the patient.

And to drive that required HCP awareness and enablement, Merck has added whitepapers, videos, case studies, and infographics that educate on patient outcomes and discuss how their patient services and products can positively affect those goals. The care liaisons also act as a central point of contact across the patient?s care team, sharing information and allowing the clinician to focus on patient care. Hospitals and clinics can identify solutions that will reduce cost of care and ideas that support broader community healthy management goals.

Janssen?s Healthcare Innovation pre-treatment offering

Janssen?s Healthcare Innovation has developed many pre-treatment services, most notably their ?Care4Today? programs. These programs provide support that begin in the pre-treatment phase and extend throughout the entire patient journey.

Their mental health solutions provide support for both the healthcare team (staff, administrators, and implementation managers) and patients from diagnosis to ongoing management. They offer patient and facilitator workbooks and videos, web and mobile tools, reminder services, and outcome analysis. Their objective is to educate everyone that?s a part of the journey to reduce relapse and re-hospitalization.

Their orthopedic solutions provide patients management programs for people undergoing orthopedic surgery. The education content is designed to help patient recovery at home and improve patient outcomes.

Janssen has plans to launch a heart health solution including a technology platform, support center, personalized exercise program, and education curriculum. These support services also include mobile health manager apps for family members to monitor medication adherence, a reward program to allocate charitable donations based on adherence, and reports that track medication schedules.

Pharmaceutical companies are partnering with HCPs, hospitals, and clinics to better support the patient during the pre-treatment phase of their journey. What service offering do you deliver?